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The Care Group, P.C.
Restless Legs Syndrome
By Gerard L. Guillory, M.D.
Various medications can make RLS worse, contact right therapist for right treatment
Restless legs syndrome (RLS) is a common condition characterized by an uncontrollable urge to move the legs in order to stop uncomfortable sensations in the lower extremities. These uncomfortable feelings, which usually occur at night, are variously described as electrical, creeping, painful, itching, and pins-and-needles. Movement, usually walking, brings immediate, although often only temporary, relief.
RLS has been receiving more attention recently as the result of direct-to-consumer advertising by pharmaceutical companies promoting various drug therapies. In our office, we seem to be seeing more cases of RLS. I am not certain if it is the result of the advertisements and increased awareness or if the incidence is actually increasing. Incidence estimates range between 2 percent and 10 percent of the general population.
My view is that both factors are leading to this virtual RLS epidemic. Let me explain.
RLS has been shown to be associated with iron deficiency and a low ferritin level. Ferritin is the storage protein for iron in the body. Ferritin levels less than 50 are frequently associated with RLS and can be corrected with appropriate iron replacement.
Optimal iron absorption requires stomach acid. Various over-the-counter and prescription medications that block stomach acid and are used to treat digestive disorders may have the unintended consequence of blocking iron absorption, leading to symptoms of RLS. The widespread use of these medications—for example, Prilosec, Nexium, Aciphex, Pepcid, Zantac, Tagamet, Pepcid—may account for this seemingly increased incidence.
The bottom line is that if you suffer from painful sensations in the lower extremity at night, which require you to get up and walk around, you should have your ferritin level checked. Various medications may make RLS worse, including medications that block acid secretion in the stomach. There are a variety of other treatment modalities that have proven to be effective in the event that your ferritin level is normal and iron supplementation is not indicated.
Gerard L. Guillory, M.D., is board-certified in internal medicine and has been practicing in Aurora, Colo., since July 1985. As an assistant clinical professor of medicine at the University of Colorado Health Sciences Center, Dr. Guillory is actively involved in teaching medical students, resident physicians, and nurse practitioner students. He has lectured extensively on the role of nutrition and disease. Over the years, he has fostered an interest in patient education and has authored three books on digestive troubles. He also has served as medical director of a Colorado-based health plan and as a health consultant to employer groups.
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